Sr. Director Network and Contracting

Umpqua Health•Roseburg, OR

10h•Hybrid

About The Position

The Senior Director of Network and Contracting provides strategic leadership for Umpqua Health’s provider network strategy and oversees all contracting activities to ensure access to high-quality, cost-effective care for members. This role is responsible for managing the Provider Relations, Credentialing, and Contracting/Network Development departments, ensuring operational excellence and compliance with regulatory requirements. The Senior Director drives innovative reimbursement strategies, including value-based care and bundled payments, and fosters strong relationships with providers, health systems, and payors to support organizational growth and performance.

Requirements

Bachelor’s degree in Business, Finance, Healthcare Administration, or related field required; Master’s degree preferred.
Fifteen year advanced experience will be considered in lieu of degree.
Minimum 8 years of provider contracting experience in a managed care environment.
Minimum 3 years of leadership experience managing multiple operational teams.
Proven experience with value-based contracting and network development strategies.
In-depth understanding of managed care, provider contracting, credentialing, and reimbursement methodologies.
Expertise in Medicare Advantage, Medicaid, value-based contracting, and alternative payment models.
Advanced negotiation and strategic planning skills.
Strong leadership and team development capabilities.
Excellent communication and relationship-building skills.
Ability to lead multiple departments and complex projects simultaneously.
Ability to think creatively and strategically to solve problems and drive innovation.

Nice To Haves

Master’s degree preferred.

Responsibilities

Define and implement network strategy aligned with organizational goals and regulatory standards.
Develop innovative contracting and reimbursement models, including value-based arrangements and alternative payment structures.
Provide executive-level guidance on network adequacy and compliance with Oregon Health Authority (OHA) requirements.
Lead and manage the Provider Relations, Credentialing, and Contracting/Network Development teams, ensuring collaboration and accountability.
Establish departmental goals, performance metrics, and continuous improvement initiatives.
Mentor and develop leadership within departments to build organizational capacity.
Oversee negotiation, drafting, and execution of provider contracts, including hospitals, physician groups, and ancillary services.
Ensure contracts meet financial performance targets and regulatory standards.
Monitor provider performance and implement strategies to address gaps and inefficiencies.
Ensure adherence to state and federal regulations, including Medicare and Medicaid requirements.
Support audits, reporting, and credentialing compliance activities.
Analyze contract performance and develop strategies to optimize cost and quality outcomes.
Collaborate with finance and analytics teams to model reimbursement scenarios and forecast financial impact.
Build and maintain strong relationships with providers, health systems, and payors to ensure network stability and growth.
Represent Umpqua Health in external meetings and negotiations as needed.